Why Americans Spend So Much on Health Care–In 12 Charts • Hacker News Board

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#41

Post by whatok » Tue, Jul 31, 2018, 3:28 PM UTC

howard941 wrote: post #12

> Consumers, meanwhile, buoyed by insurance and tax breaks, have little idea how much they are really spending and little incentive to know underlying costs. Almost weekly there's another post showing that consumers literally cannot find out costs usually because the provider cannot supply it. It's time to put a stake in the heart of the recurring blame-the-consumer trope.

Even if you got complete disclosure of costs, there is no incentive for consumers to negotiate costs because of insurance coverage. Sure, rates go up but that's a detached and opaque process.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#42

Post by burlesona » Tue, Jul 31, 2018, 3:29 PM UTC

> The health-care industry overtook the retail sector as the nation’s largest employer in December, giving local economies and their workers a stake in the industry’s growth. Health jobs surpassed manufacturing jobs in 2008.

This seems to me the biggest source of the problem. As the saying goes it’s hard to get someone to understand something when their salary depends on them not understanding it.

These days healthcare jobs - technicians and clerks and so on - are the new factory line work. Ie readily available good paying jobs that you can get (in many cases) without a college degree. These personal care jobs are also hard to replace with automation since the entire point is to deal with other humans.

Thus most people agree “the system” is broken but any specific proposal made to change it meets a big backlash of people who imagine - perhaps rightly so - “that could cost my job!”

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#43

Post by y-c-o-m-b » Tue, Jul 31, 2018, 3:29 PM UTC

Healthcare costs are by far the #1 reason why I want to move out of the U.S. as soon as possible.

I am well off, but due to recent experience I have a major anxiety about going bankrupt from another unexpected health issue. I had emergency spine surgery last year and despite coordinating everything I could to stay in network prior to entering the hospital - surgeon was in network, hospital in network, etc... - the monitoring group that was in the surgery room was NOT in network and neither was the assisting physician. Their fees were so high, that insurance refused to negotiate with them and so I was responsible for the charges despite meeting my out of pocket maximum for out of network charges.

Basically out of network maximums are worthless! If it's set at 10k and the bill comes back 100k, insurance can pay up to the 10k (if even that) and you will be responsible for 90k afterwards. It's a mess. I did some reading on this and it turns out to be a huge problem across the US, especially in states like Texas where finding in-network providers and facilities is less likely.

I remember when I started working in the early 2000s at a gas station. I was getting 100% paid medical benefits through Aetna and coverage was 90% through the insurance. As time went on and I got better jobs (in IT), that turned into a small monthly premium. Then the premiums just kept growing every year until it became a significant chunk of my monthly take-home check. Starting a few years ago, they've introduced reduced coverage all the way down to 70% as premiums continue to climb and with huge deductibles and higher out of pocket maximums. How long can they continue doing this before the whole system collapses?

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#44

Post by maxxxxx » Tue, Jul 31, 2018, 3:30 PM UTC

whatok wrote: post #33

maxxxxx wrote: post #24

Earlier quoted context omitted.

In all fairness health care costs were shooting up long before Obamacare. Obamacare just did nothing to change that trend.

What's the first word in the act's name?

I agree that it failed to achieve that goal but it also didn't make the rising health care costs worse.

You are making the big (and very american) mistake to attribute all problems to the party or president you don't like while overlooking the systemic problems that are there long term no matter who is in power.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#45

Post by chimeracoder » Tue, Jul 31, 2018, 3:30 PM UTC

knuththetruth wrote: post #23

malvosenior wrote: post #13

Earlier quoted context omitted.

You do realize that it was under democratic leadership that healthcare costs shot up so much. Obamacare increased my monthly payment almost 2X.

...implementing a healthcare policy cooked up by conservative think tanks in the 1990s. The rest of the developed world shows that anything short of national healthcare system is an expensive mistake.

> The rest of the developed world shows that anything short of national healthcare system is an expensive mistake.

Of "the rest of the developed world", only one country (the UK) has a "national healthcare system", and even that's a bit of a stretch, because England, Scotland, Wales, and Northern Ireland all have different systems.

Canada runs healthcare at the provincial level. France, Germany, Spain, the Netherlands, etc. - all of those countries use private systems that cannot reasonably be called a "national healthcare system", unless you're going to stretch the definition so far as to say that countries like India (and the US) also have national healthcare systems.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#46

Post by johan_larson » Tue, Jul 31, 2018, 3:30 PM UTC

swarnie_ wrote: post #10

Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.

A hefty portion of the population hates, fears, or scorns the government. They think putting healthcare (even more) in the hands of the state will either lead to worse results or give the state even more leverage to push them around.

Also, a big and influential portion of the citizenry is served just fine by the current arrangement. If you don't have any long-term medical conditions and you have a job good enough that your employer provides medical insurance, you're doing just fine, thank you.

Finally, there are large and influential groups that are making a lot of money under the current system, and expect they would make less under a more socialized system. Among these are doctors, insurance companies, and pharmaceutical companies.

All these factors add up to a formidable bulwark against large-scale change.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#47

Post by pjc50 » Tue, Jul 31, 2018, 3:30 PM UTC

jcadam wrote: post #26

komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

You're seriously blaming the ACA on Republicans?

Yes? Combined with the bizarre Democrat insistence on trying to play bipartisanship with people who aren't interested in reciprocating. That's what led them to push for "national Romneycare", the most conservative possible solution.

Republicans have no interest in the possibility of any kind of functioning public option, nor any kind of pro-consumer market reform that would actually deliver healthcare. It's simply not in the list of things they talk about.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#48

Post by improbable22 » Tue, Jul 31, 2018, 3:30 PM UTC

koolba wrote: post #19

swarnie_ wrote: post #10

Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.

The abridged version is that they were working on it but the head of Kaiser convinced Nixon that private health insurance was a better option. Fast forward a few decades and there is too much at stake for the companies providing the care^insurance for a graceful change. Large companies also don't give a hoot because they're able to offer corporate self-insured plans which constitutes a competitive advantage against s…

There are lots of other systems besides single-payer (like the NHS grandparent mentions liking) or the US. It isn't some law of nature that anything "in-between" is doomed to failure.

For example, read a bit about the Swiss system:

https://en.wikipedia.org/wiki/Healthcare_in_Switzerland

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#49

Post by dnomad » Tue, Jul 31, 2018, 3:30 PM UTC

rayiner wrote: post #15

komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

Do democratic politicians have some sort of training in maintaining the farce that more things should be handled by government, when governments in Illinois, California, New York, etc.--democratic strongholds where Republicans cannot be pointed to as the scapegoats--are on the verge of bankruptcy? I don't think, deep down, republicans think the current system is better. They just don't trust whatever replaces it won'…

You're really disconnected from reality of you think California and New York, the two most dynamic and wealthiest states that actually fund directly and indirectly most of the other states, are on the verge of bankruptcy. Try coming back to the real world and examining the facts. There's a very good reason why certain states are high tax and high growth while others are welfare operations that unfortunately can leverage their two senators into a kind of ransom business model.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#50

Post by knuththetruth » Tue, Jul 31, 2018, 3:31 PM UTC

malvosenior wrote: post #31

knuththetruth wrote: post #23

Earlier quoted context omitted.

...implementing a healthcare policy cooked up by conservative think tanks in the 1990s. The rest of the developed world shows that anything short of national healthcare system is an expensive mistake.

So the democrats are not to blame for implementing it? I don't see how you can single out any particular party for this situation and if I had to, I'd go with the people that actually jacked up my premiums (democrats).

Oh, they’re entirely to blame and I’m just as angry as anyone for them furthering this broken system.

But their choice of doing so was guided by right-wing ideology. The Democratic Party is a center-right party. You might not be able to single out any one party for this problem, but you can certainly indict those who further this kind of thinking in the face of its demonstrable moral and economic failure.